Individual provider Active NPI

Mohamud Hassan

  • Primary Care Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1730964776
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F08230990 Issued in WA
Practice address
1040 S Henderson St
Seattle, WA 98108-4720
Phone
(206) 763-5277
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F08230990 WA Primary

Addresses

Primary practice location

1040 S Henderson St
Seattle, WA 98108-4720

Mailing address

1040 S Henderson St
Seattle, WA 98108-4720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122003819 WA Practitioner - Nurse Practitioner 2062864374 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

24118 Bothell Everett Hwy
Unit 200
Bothell, WA 98021-9379
Phone (864) 664-3984

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F08230990WAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 22, 2023 Accepting new patients
Multicare Health System CurrentSince Dec 22, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Peacehealth Networks on Demand, LLC CurrentSince Jan 6, 2026 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

10541 NE 4th St
Bellevue, WA 98004
Phone (954) 881-4151

24118 Bothell Everett Hwy
Unit 200
Bothell, WA 98021

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

19220 Alderwood Mall Pkwy
Ste 145
Lynnwood, WA 98036

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: mhassan735222@direct.multicare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1730964776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S HENDERSON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S HENDERSON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084720",
            "telephone_number": "206-763-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MOHAMUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "F08230990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.